Paediatric Rheumatology Dr. K.P.Lee on behalf of CWG Paediatric Rheumatology

CWG Paediatric Rheumatology Dr Wilson YEUNG, PYNEH Dr Marco HO, QMH Dr Winnie CHAN, QEH Dr Alvin HUI, QEH Dr Wai Hung KU, TKOH Dr David LUK, UCH Dr Lettie LEUNG, KWH Dr Niko TSE, PMH/YCH Dr Kwok Piu LEE, AHNH Dr Grace CHIANG Dr Assunta HO, PWH Dr S N WONG, TMH Dr Samantha LI, TMH Dr. Patrick Chong, QMH

Existing services Paediatric rheumatology services are currently provided at a variable extent in all paediatrics departments of HA hospitals Designated rheumatology clinics for rheumatology patients are set up in 7 Departments, while others have integrated the rheumatology cases into renal/GI/immune/general clinics Services are provided by paediatricians with special interest in rheumatology with variable rheumatology training

No physiotherapist/occupational therapist specialized in paediatric rheumatology Only one nursing specialist work as a paediatric rheumatology nurse coordinating the service

Gap Biologics and novel Tx Intra-articular steroid injection Capillaroscopy Musculoskeletal ultrasound assessment Transitional care Expertise of medical staff, nurses and allied health

Service model in HKCH era Hub and Spokes model Complex or rare pediatric rheumatology cases to be centralized at HKCH and share care with other subspecialty for multi-system rheumatology case Local hospital to take care of acute short-lasting rheumatology condition and step-down care of stable simple rheumatology patients

HKCH In-patient care for acute severe rheumatology patients Day patient care for treatment and comprehensive assessment Out patient clinic Support local hospital/spokes : out-reach clinic and consultation, skype consultation and phone consultation Teaching and research

Spokes Number of spokes depends on remaining expertise at local hospitals Dynamic Number of spokes expected to be small initially while most of trained staff move in HKCH Taken care by staff who has special interest in rheumatology

Medical manpower at HKCH 5-6 subspecialists/trained staff 2-3 trainees for rotation and subsequent succession plan Sustainability and healthy succession for small subspecialty The Pediatric Rheumatology Workforce: A Study of the Supply and Demand for Pediatric Rheumatologists. US Department of Health & Human Services, Human Resources and Service Administration, Bureau of Health Professions. Feb, 2007. NHS STANDARD CONTRACT. PAEDIATRIC MEDICINE: RHEUMATOLOGY. NHS Commissioning Board 2013

Other support Nurse Physiotherapist Occupational therapist Other paediatric subspecialists and medical specialists like ophthalmologists and orthopaedic surgeon Other allied health like clinical psychologists, dietitians and social workers

Interim Engage interested staff Provide overseas training opportunity Networking by area (HK, Kowloon and NT) to provide service, maximize exposure and share experience Clear and transparent career path Management practice statement preparation

Subspecialty training Based at HKCH Adult rheumatology module

Thank you!